The potential for terrorist use of chemical agents is a noted concern highlighted by the Tokyo sarin gas attacks of 1995. The events of September 11, 2001, increased congressional attention towards reducing the vulnerability of the United States to
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such unconventional attacks. The
possibility that terrorist groups might obtain insecure chemical weapons led to increased scrutiny of declared Libyan chemical weapon stockpiles following the fall of the Qadhafi regime. Experts have expressed similar concerns regarding the security and use of Syrian chemical weapons,
reportedly including stocks of nerve (sarin, VX) and blister (mustard gas) agents.
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The message contained in this publication is clear: countries need a
public health system that can respond to the deliberate release of
chemical and biological agents. Regrettable though this message may
be, the use of poison gas in the war betwe
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en Iraq and the Islamic
Republic of Iran in the 1980s, the recent anthrax incidents in the United
States, and the attack with sarin nerve agent, six years earlier, on the
Tokyo underground, illustrate why it is necessary to prepare.
Russian and Japanese version available:
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This course describes the health effects of war, weapons and strategies of violent conflict. Beginning with weapons of mass destruction it then moves on to other
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weapons and strategies of war such as the use of landmines and mass rape. The course concludes with a number of lessons which give an historical and practical analysis of the response of health professional groups to war and militarisation.
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The use of explosive weapons, such as bombs, rockets, and mortar and
artillery shells, in cities, towns and villages and in other populated areas
has devastating humanitarian consequences. Explosive
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weapons act mainly
through the projection of blast and fragmentation within an area. Their use,
in populated areas, causes severe suffering to civilians, both in terms of
death and serious injury resulting directly from the explosion, and in terms
of damage to property and public infrastructure, which can indirectly affect
civilian well-being and survival, sometimes for many years after a conflict
has ended. Explosive weapons also leave behind explosive remnants that
pose a threat to populations until those remnants are removed. [...] The study finds that the regulation of explosive weapons under international
law and policy is fragmentary and incoherent.
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This Guide contains information, guidelines, diagrams and other materials addressed to medical practitioners who are engaged in the treatment of casualties of chemical weapons. It is made available
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to the public for information purposes, but is not intended to be used by the public. All decisions regarding patient care must be made with a healthcare provider and consider the unique characteristics of each patient.
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"National Disaster Management Guidelines: Management
of Chemical (Terrorism) Disasters (are intended to
focus on all aspects of the disaster management
cycle, including prevention measures such as
surveillance and intelligence, mitigation of dir
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ect
and indirect risks, preparedness in terms of
capacity development of human resources and
infrastructure development, as well as relief,
rehabilitation and reconstruction/recovery."
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Reducing the humanitarian impact of the use of explosive weapons in populated areas is a key priority for the United
Nations, the International Committee of the Red Cross (ICRC), civil society and an increasing number of Member States.
The Unite
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d Nations Secretary-General has expressly called on parties to conflict to avoid the use in populated areas of
explosive weapons with wide-area effects.
While the use of explosive weapons in populated areas may in some circumstances be lawful under international
humanitarian law (IHL), empirical evidence reveals a foreseeable and often widespread pattern of harm to civilians,
particularly from explosive weapons with wide-area effects.
Many types of explosive weapons exist and are currently in use. These include air-delivered bombs, artillery projectiles,
missiles and rockets, mortar bombs, and improvised explosive devices (IEDs). Some are launched from the air and
others are surface launched. Whilst different technical features dictate their accuracy of delivery and explosive effect,
these weapons generally create a zone of blast and fragmentation with the potential to kill, injure or damage anyone
or anything within that zone. This makes their use in populated areas – such as towns, cities, markets and camps for
refugees and displaced persons or other concentrations of civilians – particularly problematic. The problems increase
further if the effects of the weapon extend across a wide-area either because of the scale of blast that they produce; their
inaccuracy; the use of multiple munitions across an area; or a combination thereof.
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In 2005, the World Health Organization (WHO) Member States adopted the revised International
Health Regulations (IHR) (2005). The Regulations provide a unique public health framework in the
form of obligations and recommendations that enable countries to better p
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revent, prepare for and
respond to public health events and emergencies of potential international concern, including chemical events.
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The Syrian Government’s Widespread and Systematic Use of Chemical Weapons
The risks of the use of nuclear, radiological, biological or chemical (NRBC) weapons are heterogeneous. Each risk has its own implications for developing and deploying any capacity to assist victims
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of an NRBC event and, in parallel, for the health and security of the people bringing this assistance. At an international level, there are no plans for assisting the victims of an NRBC event which are both adequate and safe. Recognizing
the realities of the contexts associated with each risk throws up numerous challenges; such recognition is also a prerequisite for addressing these challenges. The realities that have to be considered relate to:
1. developing, acquiring, training for and planning an NRBC response capacity;
2. deploying a response capacity in an NRBC event;
3. the mandates and policies of international organizations pertaining to NRBC events. The challenges that will pose the greatest difficulty for a humanitarian organization are those for which the solutions are ‘non-buyable’ and which involve making extremely difficult decisions. Attempting to assist victims of an NRBC event without a reality-based approach might generate ineffective and unacceptably dangerous situations for those involved.
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"Patient decontamination principles are set forth here from a strategic perspective, rather than a tactical
one. The principles are meant to guide, but not specify, operational practices. The guidance is evidencebased
to the extent possible and the supporting evidence is documented and briefly dis
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cussed."
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In this paper, we review the most significant health and environmental facts and explain why — from a medical perspective — a proper understanding of what nuclear weapons will do invalidates all arguments for continued possession of t
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hese weapons and requires that they urgently be prohibited and eliminated as the only course of action commensurate with the existential danger they pose.
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This document provides information for WHO Member States, particularly low-income and middle-income countries, to strengthen preparedness and response plans with regard to the social and mental health consequences of biological and chemical attacks.
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States, the United Nations and civil society organisations continue to raise concerns about the humanitarian impact caused by the use of explosive weapons in populated areas (EWIPA). This issue is currently being examined from political, legal, soci
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o-economic and humanitarian perspectives. The GICHD has undertaken research to provide a technical perspective on the destructive effects of selected explosive weapons to inform the international debate.
The research project attempts to reduce an observed knowledge gap regarding EWIPA. It seeks to provide clarity concerning the immediate physical effects and terminology used when discussing explosive weapons. The project is guided by a group of experts dealing with weapons-related research and practitioners who address the implications of explosive weapons in humanitarian, policy, advocacy and legal fields.
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This interim guidance is aimed at healthcare workers who may receive patients
exposed to chemical weapons at their healthcare facilities.
It provides questions to guide the identification
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of contaminated patients,
recommendations on personal protection, procedures for decontamination,
guidance for triage and identification of categories of exposure, and treatment
regimens for individual chemicals.
Arabic version available: http://www.who.int/environmental_health_emergencies/deliberate_events/interim_guidance_ar.pdf
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A chemical release may not always be immediately apparent given the fact that many agents are odourless and colourless, and some cause no immediately noticeable effects or symptoms. Be alert to the possible presence of a
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chemical.
Arabic version available: http://www.who.int/environmental_health_emergencies/deliberate_events/warning_signs_May2017_ar.pdf
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The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume series entitled Managing Hazardous Material Incidents. The series is designed to help emergency response and health care professionals plan for and respond to hazardous material emergencies.
- Volume I Emergenc
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y Medical Services: A Planning Guide for the Management of Contaminated Patients
- Volume II Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients
- Volume III Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to hazardous materials.
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A fact sheet from the National Academies and the U.S. Department of Homeland Security
Mounting an effective international humanitarian response to a chemical, biological, radiological or nuclear (CBRN) event, especially if the response is undertaken on an ad hoc basis, would be extremely difficult and would pose many risks to the res
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ponders. The International Committee of the Red Cross (ICRC) has created a competency-based capacity to respond to at least small-scale CBRN events, including a deployable capability to undertake operational activities. This involves informed assessments of CBRN risks, timely and competent decisions on how to respond, and effectively mobilizing appropriate resources to implement these decisions, through the creation of an emergency roster. In addition to the acquisition of technical expertise and material resources, the creation of such capacity requires the application of central processes, ensuring systematic management of CBRN response (including risk-based decision-making), standing operational procedures, and availability of and access to the necessary resources. Implementation of the ICRC's CBRN response framework as described in this article should be considered by any agency or other stakeholder preparing for international humanitarian assistance in CBRN events – especially if such events are related to armed conflict.
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